Pharmacotherapy Flash Cards 9780071794084, 0071794085, 9780071741156, 0071741151

Table of contents :
Cover
Title Page
Copyright Page
Contents
Preface
Acknowledgments
About the Authors
Abbreviations
Adult Reference Values for Laboratory and Other Tests
1 Cardiovascular Disorders
2 Dermatologic and Ophthalmic Disorders
3 Endocrine Disorders
4 Gastrointestinal Disorders
5 Hematologic and Oncologic Disorders
6 Immunology and Transplant
7 Infectious Diseases
8 Men’s and Women’s Health
9 Neurologic Disorders
10 Nutrition
11 Pain Management
12 Preventative Health
13 Psychiatric and Substance Abuse Disorders
14 Renal Disorders
15 Respiratory Disorders
16 Rheumatologic Disorders
Bibliography
Index
A
B
C
D
E
F
G
H
I
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Z

Citation preview

Pharmacotherapy Flash Cards Jeremy L. Johnson, PharmD, CDE

Kimberly M. Crosby, PharmD, BCPS, CGP

Ann E. Lloyd, PharmD, BCPS

Kelly Murray, PharmD

Michelle E. Condren, PharmD, AE-C, CDE

New York Chicago San Francisco Lisbon London Madrid Mexico City Milan New Delhi San Juan Seoul Singapore Sydney Toronto

Notice Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the information contained herein with other sources. For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs.

Copyright © 2011 by McGraw-Hill Education. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher. ISBN: 978-0-07-179408-4 MHID: 0-07-179408-5 The material in this eBook also appears in the print version of this title: ISBN: 978-0-07-174115-6, MHID: 0-07-174115-1. eBook conversion by codeMantra Version 1.0 All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occurrence of a trademarked name, we use names in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the trademark. Where such designations appear in this book, they have been printed with initial caps. McGraw-Hill Education eBooks are available at special quantity discounts to use as premiums and sales promotions or for use in corporate training programs. To contact a representative, please visit the Contact Us page at www.mhprofessional.com. TERMS OF USE This is a copyrighted work and McGraw-Hill Education and its licensors reserve all rights in and to the work. Use of this work is subject to these terms. Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy of the work, you may not decompile, disassemble, reverse engineer, reproduce, modify, create derivative works based upon, transmit, distribute, disseminate, sell, publish or sublicense the work or any part of it without McGraw-Hill Education’s prior consent. You may use the work for your own noncommercial and personal use; any other use of the work is strictly prohibited. Your right to use the work may be terminated if you fail to comply with these terms. THE WORK IS PROVIDED “AS IS.” McGRAW-HILL EDUCATION AND ITS LICENSORS MAKE NO GUARANTEES OR WARRANTIES AS TO THE ACCURACY, ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING THE WORK, INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. McGraw-Hill Education and its licensors do not warrant or guarantee that the functions contained in the work will meet your requirements or that its operation will be uninterrupted or error free. Neither McGraw-Hill Education nor its licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of cause, in the work or for any damages resulting therefrom. McGraw-Hill Education has no responsibility for the content of any information accessed through the work. Under no circumstances shall McGraw-Hill Education and/or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them has been advised of the possibility of such damages. This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise.

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Contents Preface Acknowledgments About the Authors Abbreviations Adult Reference Values for Laboratory and Other Tests 1 Cardiovascular Disorders

vii ix x xii xix 1

8 Men’s and Women’s Health

141

9 Neurologic Disorders

150

10 Nutrition

159

11 Pain Management

165

12 Preventative Health

174

13 Psychiatric and Substance Abuse Disorders

179

2 Dermatologic and Ophthalmic Disorders

28

14 Renal Disorders

197

3 Endocrine Disorders

38

15 Respiratory Disorders

206

4 Gastrointestinal Disorders

53

16 Rheumatologic Disorders

225

5 Hematologic and Oncologic Disorders

81 Bibliography Index

239 242

6 Immunology and Transplant 7 Infectious Diseases

94 100

v

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Preface The purpose of the Pharmacotherapy Flash Cards is to aid pharmacy and other health professional students in the practice of pharmacotherapeutic decision making using case studies. As faculty members of the University of Oklahoma, College of Pharmacy, we use case studies all throughout our curriculum to allow students to apply newly learned information. Case studies can bring an element of real-life clinical practice into the classroom and help students to start thinking like clinicians. Repeated exposure to this way of thinking can only help to develop and polish critical-thinking skills that will be used throughout students’ careers. We want to bring this element to students so they can test their pharmacotherapeutic knowledge and hone their skills anytime they want. Pharmacotherapy Flash Cards provides a comprehensive review of pharmacotherapeutic concepts for each of the major disease states commonly encountered by clinicians in practice. Essentially, it condenses the highlights and clinical pearls from therapeutics courses or modules in pharmacy schools to emphasize appropriate, evidence-based therapeutic decision making and drug therapy monitoring. A standard formatted case on the front of each card introduces students to a systematic flow of thinking when gathering patient health information and builds toward making therapeutic recommendations or decisions. Cases are designed to put the future healthcare provider into different potential scenarios where therapeutic decisions must be made (eg, a pharmacy, clinic, provider office visit, hospital, etc.). Each case is followed by a therapeutic question. The answer may call for a specific drug or a general drug class. Many aspects of the case must be considered to determine the most appropriate answer. This may include past medical history, medication history, allergies, physical exam and other studies, and laboratory or other test results. To accommodate different learning styles, some questions are asked directly, vii

while others are presented in a multiple-choice format. At the top of the back of each card is the answer to the question—either a drug or drug class with each agent in the class listed. This is followed by drug information commonly used or considered when using these medications. This includes the mechanism of action, contraindications, precautions, adverse effects, and monitoring parameters. The back of each card also includes a section called “Case Notes” where the answer to the case is explained along with other clinical pearls about use of the drug or drug class, management of the disease, and dosing. We want to bring a quality and meaningful learning tool that students will find to be valuable and convenient to use. These flash cards may be used as an adjunct to information learned in the classroom while students review for exams, or even as a review tool when preparing for the licensure examination. Aside from using these cards to solve clinical cases, some students may find value in simply studying the backs of cards for general recognition of routine drug information. We are proud to present Pharmacotherapy Flash Cards as a current and evidence-based learning tool. We are confident students will find this to be a valuable tool for reviewing drug information and for developing critical-thinking skills and an approach to clinical decision making. We believe these flash cards will help many students through challenging therapeutics courses while enhancing retention of knowledge through application in real clinical scenarios. We are excited to receive feedback from our readers and welcome comments on how to improve upon this study tool in the next edition.

viii

Acknowledgments We would like to thank the editors at McGraw-Hill for their expertise and assistance in bringing this publication to fruition. We would like to thank the faculty and administrative staff of the University of Oklahoma College of Pharmacy for their support and guidance throughout this process. We especially appreciate Dr. Shane Desselle for identifying this opportunity and for his encouragement and enthusiasm throughout the project. Finally, we would like to thank our family and friends for their understanding and support throughout this experience.

ix

About the Authors Dr. Jeremy L. Johnson is an Assistant Professor for the University of Oklahoma College of Pharmacy, Department of Clinical and Administrative Sciences in Tulsa. He has been on faculty with the College of Pharmacy since 2001. Dr. Johnson earned his Bachelor of Pharmacy and Doctor of Pharmacy degrees from the University of Oklahoma and completed a Pharmacotherapy Specialty Residency in Family Medicine, with emphasis in ambulatory care, at the University of Texas Health Science Center at San Antonio. He spent three years practicing in Lawton/Ft. Sill, Oklahoma at the US Army base hospital outpatient clinic. Since transferring to the OU-Tulsa campus, he has practiced with the Department of Internal Medicine and currently with the Department of Family Medicine. His current practice specialties include diabetes, hypertension, dyslipidemia, and asthma education and management services. Research interests include cardiovascular and diabetes clinical outcomes as well as educational research. He has been recognized with teaching and precepting honors. Dr. Johnson is a Certified Diabetes Educator and the associate director of a PGY2 residency in ambulatory care. Dr. Michelle Condren is an Associate Professor and Vice-Chair for the University of Oklahoma College of Pharmacy, Department of Clinical and Administrative Sciences in Tulsa. She is also an Associate Professor with the University of Oklahoma School of Community Medicine, Department of Pediatrics. Dr. Condren joined the College of Pharmacy faculty in January of 2006. Prior to coming to OU, she was a faculty member at the Texas Tech School of Pharmacy in Amarillo from 1999 to 2005. Dr. Condren earned her Bachelor of Pharmacy and Doctor of Pharmacy degrees from the University of Oklahoma and completed a pediatric specialty residency at Texas Tech University School of Pharmacy. Her practice areas are ambulatory general pediatrics, cystic fibrosis, asthma, and diabetes. Research interests include medication safety, pediatric competency for pharmacists, and quality improvement. She has been recognized for her practice initiatives at the national level. Dr. Condren currently serves as the director of a PGY2 residency in ambulatory care. Dr. Kimberly Crosby has served as a faculty member for the University of Oklahoma College of Pharmacy, Department of Clinical and Administrative Sciences since July 2002. Prior to coming to OU, she held the position of Assistant Professor for Southwestern Oklahoma State University College of Pharmacy from 2000 to 2002. Dr. Crosby received her Bachelor of Sciences in Pharmacy from Southwestern Oklahoma State University in 1990 x

and her Doctor of Pharmacy from the University of Oklahoma in 1999. She completed a Pharmacy Practice Residency at Saint Francis Hospital in Tulsa, OK in 2000. Dr. Crosby served as the Residency Director for the OU/May’s Drug Stores Community Pharmacy Residency Program from 2005 to 2009. Dr. Crosby’s current clinical practice is with the OU College of Medicine Family Medicine Department in Tulsa. Her practice and research interests are in the areas of cardiovascular disease, asthma, smoking cessation, and diabetes. Dr. Ann Lloyd is an Assistant Professor at the University of Oklahoma College of Pharmacy, Department of Clinical and Administrative Sciences in Tulsa. She received her Doctor of Pharmacy degree in 2003 from the University of Kansas and completed a pharmacy practice residency at Barnes-Jewish Hospital/Washington University Medical Center in St. Louis. She is a Board-Certified Pharmacotherapy Specialist. Dr. Lloyd currently serves as the clinical pharmacy specialist in Infectious Diseases at Saint Francis Hospital in Tulsa. Her area of practice focuses on antimicrobial stewardship. In addition to her clinical service, Dr. Lloyd teaches in the College of Pharmacy Therapeutics courses. Her primary areas of interest and research are antimicrobial stewardship, pharmacodynamics, and teaching critical thinking and problem solving. Dr. Kelly Murray is a Clinical Assistant Professor at the University of Oklahoma College of Pharmacy, Department of Clinical and Administrative Sciences in Tulsa, OK. She is also the Clinical Services Coordinator for USA Drug pharmacies. She received her Doctor of Pharmacy degree in 2007 from the University of Oklahoma. College of Pharmacy and completed a Community Pharmacy Practice residency at USA Drug in 2008. She practices primarily in medication therapy management, chronic disease state management, and immunization clinics in the community pharmacy setting. Dr. Murray’s primary research interests include community pharmacists’ care of migraine headaches and sensitivity to health literacy issues. In addition to clinical practice and research, Dr. Murray teaches in the nonprescription products, clinical communications, and advanced diabetes care courses. She currently serves as the director for a PGY1 community pharmacy practice residency. xi

Abbreviations 5-HT AACE ABG ACE ACIP ADA ADHD AED AIDS AlkPhos ALT AML AMP ANC APAP ARB

ASA AST ATP-III AV BB BCG BNP BP BPH BSA BUN Ca CABG CAD CBC CCB CCR5 CD CF CHC

serotonin American Association of Clinical Endocrinologists arterial blood gases angiotensin-converting enzyme Advisory Committee on Immunization Practices American Diabetes Association attention deficit hyperactivity disorder antiepileptic drugs acquired immunodeficiency syndrome alkaline phosphatase alanine aminotransferase acute myelogenous leukemia adenosine monophosphate absolute neutrophil count acetaminophen angiotensin receptor blocker xii

aspirin aspartate aminotransferase Third Adult Treatment Panel atrioventricular beta-blocker bacille Calmette-Guérin vaccine brain natriuretic peptide blood pressure benign prostatic hyperplasia body surface area blood urea nitrogen calcium coronary artery bypass graft coronary artery disease complete blood count calcium channel blocker specific HIV cellular binding site Crohn’s disease cystic fibrosis combined hormonal contraceptive

CHF CHOP

Cl Clcr CNS CO2 COMT COPD COX CP CPK CPT CR CRP CT scan CTA CVD

chronic heart failure cyclophosphamide, hydroxydaunorubicin (doxorubicin), Oncovin (vincristine), and prednisone/ prednisolone chloride creatinine clearance central nervous system carbon dioxide catechol-O-methyl transferase chronic obstructive pulmonary disease cyclooxygenase chest pain creatine phosphokinase chest percussion therapy controlled release C-reactive protein computed tomography scan clear to auscultation cerebrovascular disease

CVP CXCR4 CYP DHP DKA dL DMARD DNA DPP-IV DVT DXA ECG ED EE EEG ELISA ESR ESRD F xiii

central venous pressure specific HIV cellular binding site cytochrome P450 dihydropyridine diabetic ketoacidosis deciliter disease-modifying antirheumatic drug deoxyribonucleic acid dipeptidyl peptidase IV deep vein thrombosis dual-energy x-ray absorptiometry electrocardiography erectile dysfunction ethinyl estradiol electroencephalogram enzyme-linked immunoabsorbent assay erythrocyte sedimentation rate end-stage renal disease Fahrenheit

FDA FEV1 FSH FT4 FVC G6PD GABA GERD GI GLP-1 Glu GYN H pylori HA HAV HBV Hct HDL HFA Hgb HIPA

Food and Drug Administration forced expiratory volume in 1 second follicle-stimulating hormone free thyroxine forced vital capacity glucose-6-phosphate dehydrogenase gamma-aminobutyric acid gastroesophageal reflux disease gastrointestinal glucagon-like peptide 1 glucose gynecologist Helicobacter pylori headache hepatitis A virus hepatitis B virus hematocrit high-density lipoprotein hydrofluoroalkane hemoglobin heparin-induced platelet aggregation

HIV human immunodeficiency virus HLA human leukocyte antigen HMG-CoA 3-hydroxy-3-methylglutarylcoenzyme A HPA hypothalamic-pituitary-adrenal HPV human papillomavirus HR heart rate Ht height HTN hypertension IBD inflammatory bowel disease IBS irritable bowel syndrome IBW ideal body weight IgA immunoglobulin A IgE immunoglobulin E IL-2 interleukin 2 IM intramuscular In inches INR international normalized ratio IPV inactivated polio vaccine IV intravenous JNC-7 Seventh Joint National Committee xiv

K KPhos LABA LAIV Lbs LDL LFT LH LHRH MAO MAP mcg MCV MDI mEq Mg mg MI mL mmHg

potassium potassium phosphate long-acting beta2 agonist live attenuated intranasal vaccine pounds low-density lipoprotein liver function tests luteinizing hormone luteinizing hormone-releasing hormone monoamine oxidase mean arterial pressure microgram mean corpuscular volume metered-dose inhaler milliequivalent magnesium milligram myocardial infarction milliliter millimeters of mercury

MMR MRSA MS Na NCEP NE NH3 NH4 NIH NKDA NNRTI NPH NRT NRTI NSAID NSCLC NSTEMI xv

measles mumps rubella methicillin-resistant S. aureus multiple sclerosis sodium National Cholesterol Education Program norepinephrine ammonia ammonium National Institutes of Health no known drug allergies nonnucleoside reverse transcriptase inhibitor neutral protamine hagedorn nicotine replacement therapy nucleoside reverse transcriptase inhibitor nonsteroidal anti-inflammatory drug non-small cell lung cancer non-ST-segment elevation myocardial infarction

NTG NYHA O2 sat OA OB OCD OTC PAOP PCP PDE PE PEF PEG-ELS PI PIP Plt PN po PO4 ppd

nitroglycerin New York Heart Association oxygen saturation osteoarthritis obstetrician obsessive compulsive disorder over the counter pulmonary artery occlusion pressure primary care provider phosphodiesterase pulmonary embolism peak expiratory flow polyethylene glycol electrolyte lavage solution protease inhibitor proximal interphalangeal platelet parenteral nutrition by mouth phosphate pack per day

PPI PPSV PR PRN PSA PT PT PTH PTT PUD PUVA PVD QRS QTc RA RAAS RBC REM RNA RR xvi

proton pump inhibitor pneumococcal polysaccharide vaccine 23-valent ECG deflection as needed prostate-specific antigen physical therapy prothrombin time parathyroid hormone partial thromboplastin time peptic ulcer disease psoralen and ultraviolet light peripheral vascular disease ECG deflection corrected QT interval rheumatoid arthritis renin-angiotensin-aldosterone system red blood cell rapid eye movement ribonucleic acid respiratory rate

RSV SABA SCr SERM SG SIADH SLE SOB SQ SSRI STEMI SVR T T4 Tbili TC TCA Td

respiratory syncytial virus short-acting beta2 agonist serum creatinine selective estrogen receptor modulator serum globulin syndrome of inappropriate antidiuretic hormone systemic lupus erythematosus shortness of breath subcutaneous selective serotonin reuptake inhibitor ST-segment elevation myocardial infarction systemic vascular resistance temperature thyroxine total bilirubin total cholesterol tricyclic antidepressant diphtheria and tetanus toxoids

Tdap

tetanus, diphtheria, and acellular pertussis vaccine TG triglyceride TIA transient ischemic attack TIV trivalent inactivated influenza vaccine TMJ temporomandibular joint TMP-SMZ trimethoprimsulfamethoxazole TNF tumor necrosis factor TPMT thiopurine methyltransferase TPN total parenteral nutrition TSH thyroid-stimulating hormone TT4 total thyroxine TZD thiazolidinedione U-100 100 units/1 mL U-500 500 units/1 mL UC ulcerative colitis UVB type B ultraviolet VIP vasoactive intestinal peptide VL viral load xvii

VRE VTE VQ VZV WBC

WHO WNL Wt XR

vancomycin-resistant enterococcus venous thromboembolism ventilation/perfusion varicella zoster virus white blood cell

xviii

World Health Organization within normal limits weight extended release

Adult Reference Values for Laboratory and Other Tests SERUM PLASMA A1c, hemoglobin Albumin AlkPhos ALT Ammonia Amylase AST Bilirubin, direct Bilirubin, total BUN Calcium Chloride (Cl) Cholesterol, total CO2 CPK Creatinine (Cr) CRP Ferritin Folate Glucose, fasting

4.0-5.6% 3.2-5 g/dL 33-131 IU/L 10-35 IU/L 20-70 mcg/dL 30-110 units/L 20-48 IU/L 0-0.3 mg/dL 0.1-1.2 mg/dL 7-20 mg/dL 8.6-10.3 mg/dL 95-108 mEq/L